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Tuesday, 17 September 2013 11:36

Great Expectations-Our Preconception Plan

We had a great visit with the midwife this morning to talk about baby #3.  I feel so at home with Sharon (our "hospital" midwife, and the woman who delivered #2), having a personal and professional relationship with her, and I know she really listens to me.  I dragged the hubby along for our preconception appointment, somewhat for moral support, but mostly because he is completely clueless about pregnancy and childbirth and I want him to glean some info from our meetings.  Of course being so clueless means that he doesn’t understand why we would even need a preconception appointment.  Silly goose.

Preconception appointments might seem trivial to some, but for a woman nearly DYING to have a baby, it can mean all the difference.  First and foremost, in order to conceive a healthy baby, you first need to have your own health squared away.  Your care provider may ask you questions about your general lifestyle such as diet and exercise, if you have a family history of high blood pressure or thyroid disease, if you smoke or drink, or even if you regularly soak in a hot tub or sauna.  These may not seem like super important issues, but they can all affect your ability to conceive- and once pregnant, can affect the health of your baby.  Your doctor or midwife will also ask you questions about your cycles.  Are you periods regular?  How long is your cycle?  Do you know when you ovulate?  (All of these questions and more can be easily answered if you practice FAM (Fertility Awareness Method)!  I can often tell you exactly when I ovulated, sometimes down to the hour, and without wasting money on those pesky and notoriously misleading OPKs.)

If this is your first baby, you might be asked about genetic screening at the preconception appointment.  But since we already have 2 healthy babies, this isn’t really something we’re too worried about.

After all the paperwork and Q and As are done, you will most likely have a physical exam.  My appointment today got cut short by a meeting among the midwives so I’ll go back tomorrow for the physical part.  It’s mostly typical stuff that you’ve already experienced if you’ve ever had a PAP smear.  They will check your blood pressure and take your weight.  They may take a swab of your cervix. If it’s been less than a year since your last OBGYN appointment, they might skip that.  I have a history of ovarian cysts and cervical problems so my midwife will check my ovaries for lumps and bumps and use the speculum for a glimpse of my cervix. 

As with most appointments you’ll probably be asked to leave a urine sample so they can check for pregnancy (wouldn’t that be easy?!), your blood sugar level for a diabetes test, or for UTI (urinary tract infection). 

And the least pleasant part is the blood draw.  While this step is entirely optional, I highly recommend it.  Your care provider can use the blood sample to check your iron levels (being pregnant can make anemia much worse, so it’s best to catch it early), HIV and STDs (of which can be very dangerous and potentially deadly to both you and the baby), and your immunities to rubella and varicella (chicken pox).  I’m a complete needle-phobe and I suffer through it.

If you’ve been trying to conceive for a long time, you might consider getting your thyroid checked, especially if you have issues with hormonal imbalances and the inability to gain/lose weight reasonably.  Your thyroid not working up to par can certainly effect your ability to get pregnant.

All in all, the appointment should be pretty straight forward.  Of course, the most important part of this appointment should be for you to ask any questions you might have about conceiving or the early days of pregnancy.  This is an especially good time to talk about and problems or concerns you might have.  Don’t be shy.  No matter how embarrassing you think your question might be, your doctor or midwife had heard it all before.  They will be able to offer you advice or refer you to specialists that you might not receive if you don’t speak up. 

Here are some great questions for you to ask at your preconception appointment:

  • What, if any, methods of family planning do you recommend?
  • When should I start taking a folic acid supplement?
  • Are there any vaccines or screenings I might consider before getting pregnant?  Am I due for a PAP smear?  Should I be tested for HIV or any STDs?
  • Discuss any existing health problems you may have or foresee having.  Ask how pregnancy or childbirth may affect or be affected by these health problems. 
  • Discuss any medications you are using, including prescriptions, OTC medicines, and herbal or natural supplements.
  • What are the ways you can improve your overall health and avoid illness?
  • When should you quit smoking, and how?
  • How will drinking alcohol affect your ability to conceive?
  • Are there any hazards in your home or workplace that could affect pregnancy?
  • Are there any genetic disorders that you should be concerned about?  What about hereditary concerns such as blood pressure, depression/anxiety, and diabetes?  What about in your partner’s family?
  • Discuss any problems you have had with previous pregnancies, such as miscarriage (or abortion), gestational diabetes, preterm labor or birth.  Discuss the births of your previous children, such as were they vaginal or surgical deliveries?  Any complications?  How long should you wait in between births?
  • And be sure to discuss any support concerns or domestic violence.  If you have a history of trauma, such as sexual abuse, it is also important to be honest and open with your care provider about this as well, as it can greatly affect your emotional well-being during pregnancy and childbirth.

Another reason to book that preconception visit is to use it as an opportunity to shop around for your care provider.  If you are on the fence about home birth v. hospital birth or are unsure about which doctor or midwife you want there for you on your big day, this is an excellent opportunity to take them for a spin.  You might walk into your appointment and be disappointed by the lack of attention you receive or you might feel like your doctor isn’t really listening to your concerns.  You might even be surprised by how quickly they rush you along and out of the office.  These are all huge red flags that you might want to find a different support team.  It’s much better to find this out before you are pregnant.  Of course the decision of who and where can always be addressed later, but I like to be prepared.

A healthy pregnancy and eventually a healthy baby all starts with a healthy mommy, so get that preconception appointment in the books!

Peace and love,
Nik

Published in Nik's Blog
Wednesday, 11 September 2013 17:18

Great Expectations-It's Time!!

It feels like it’s been forever since the last time I felt a child wiggle in my tummy.  In reality, it’s only been 3 short years since the birth of our last child.  Since I started having babies at the age of 21, I’ve been one of those women who is eternally ready for another baby.  Laying on the hospital bed after our youngest child was born, my first thought (after the impassioned cries of “it’s MY baby!”) was “when can I do this again?!”

According to my midwife, who took me in at nearly 24 weeks as a high risk patient having just been diagnosed with cervical cancer, I needed to wait at least 2 years to let my cervix heal.  Fortunately, the areas of my cervix affected were easy to treat and after a quick round of snip-snip-here and scrape-scrape-there, I found myself cancer free.  I had suffered months of torturous preterm labor with my sweet baby girl, starting at 24 weeks and ending in a 19 minute delivery at 36+4 weeks.   Having another pregnancy so close to her birth could have been very bad, so I begrudgingly decided to heed my midwife’s advice and postpone baby #3.

There has hardly been a day that passed since then that I haven’t thought “Today would be a great day to be pregnant!”  When the 2 year mark rolled around and I got the go-ahead to conceive a pint-size person, my husband was quick to throw up a stop sign.  We were in the middle of some very heavy life changes and we weren’t in a good place to be welcoming another child into our family.  We decided to revisit the idea in a year.  A long, looooong year.

And that time is now.  Hubby and I sat down and had “the talk.”  And we have unanimously chosen to have another baby.  I can hardly contain my excitement!

Being a birth doula by trade and a birth junkie by nature, I have a whole bookshelf of books I read (and reread) about fertility, pregnancy, birth, and so on.  One of my favorite go-to books is “Taking Charge Of Your Fertility” by Toni Weschler (which you can pick up at Amazon here, or at your local bookstore).  If you are thinking about giving pregnancy a shot, or if you are fed up with your hormonal birth control and are looking for a reliable and natural option, you should definitely get a copy of your own!  The Fertility Awareness Method (FAM) is, in my opinion, one of the greatest conception aids out there.  When we were trying for our youngest, for 17 stressful months, I was at my wits end and wondering why I couldn’t get pregnant after having so easily conceived our first child.  It wasn’t until I discovered TCOYF and FAM that I really got to understand my body and how conception truly works.  We fell pregnant less than 3 months after I started charting.

As soon as hubby agreed to start trying again, I brushed off my copy and cozied up in my chair for a refresher course on the miracle of conception.  I picked up a basal thermometer ($7 at Wal-Mart, or any digital to the tenth thermometer will do) and anxiously awaited the arrival my menstrual cycle to get started.  I’m only half-heartedly charting my cycle this month and trying to focus more on familiarizing myself with my body.  There is so much that happens down there!  Cervical fluid changes, high or low, open or closed, temps up, temps down.  And it all comes together to create a beautiful place to make a baby.  The female body is so amazing!

I’m so ready to have a wiggly bundle of love in my tummy again.  I’ve started taking a prenatal vitamin and am upping my daily amount of protein.  I’ve already made a preconception appointment with the midwife that delivered our daughter, and I’m compiling a list of questions.  I might be just a tad over-zealous. 

There is no greater joy than that of bringing a baby into the world, and I can’t wait to share this journey with you.

Peace and love,
Nik

Published in Nik's Blog

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